Tags: USMLE® Step 3 and COMLEX® 3
Consensus opinion provided by William Gossman, MD; Phil Hynes, MD; and James Hughes, MD
The United States Medical Licensing Examination (USMLE) Step 3 and Comprehensive Osteopathic Medical Licensing Examination (COMLEX) are two-day computer-based multiple-choice exams most commonly completed during the first year of residency training.
USMLE® Step 3 and COMLEX® Step 2 assesses the application of medical knowledge and understanding of biomedical and clinical science necessary for the unsupervised practice of medicine in ambulatory settings. Step 3 content reflects a data-based model of general medical practice. The test items and cases reflect clinical situations that a physician in general practice might encounter. Step 3 provides a final assessment of physicians that are about to assume independent responsibility for delivering general medical care.
USMLE® STEP 3 SUMMARY
The first day of the Step 3 examination covers Foundations of Independent Practice (FIP), and the second day covers Advanced Clinical Medicine (ACM).
- Day 1
- Examination length: six 60-minute sessions administered with one 15-minute computer tutorial and one 45 minute self-scheduled break
- Number of questions: 232 with 38 to 39 questions per session
- Question type: multiple-choice, single best answer
- Time: approximately 90 seconds per question
- Day 2
- Examination length: six 60-minute sessions administered with one 15-minute computer tutorial and one 45 minute self-scheduled break
- Number of questions: 180 with 30 questions per session
- Question type: multiple-choice, single best answer
- Time: approximately 90 seconds per question
- Case simulations: 13, 10-20-minutes each
USMLE® STEP 3 TOPICS
Day 1 - Step 3 Foundations of Independent Practice (FIP)
- Assessment of knowledge of basic and scientific principles essential for effective health care
- Application of foundational sciences
- Understanding of biostatistics, epidemiology, and public health
- Interpretation of the medical literature
- Application of social sciences, communication, interpersonal skills, medical ethics, systems-based practice, and patient safety
- Assessment of knowledge of diagnosis and management, history and physical examination, and use of diagnostic studies
Day 2 - Step 3 Advanced Clinical Medicine (ACM)
- Assessment of knowledge of health and disease in the context of patient management and the evolving manifestation of disease
- Assessment of knowledge of diagnosis and management, prognosis and outcome, health maintenance and screening, therapeutics, and medical decision making
- Knowledge of history and physical examination, and use of diagnostic studies
COMLEX® STEP 3 SUMMARY
The COMLEX® Level 3 is similar to COMLEX® Level 2. The questions on the COMLEX® Level 3 will probably include a more detailed clinical scenario.
The exam consists of 550 multiple choice questions and up to 30 additional clinical decision-making cases.
COMLEX® STEP 3 TOPICS
- Emergency medicine
- Family medicine
- Internal medicine
- Obstetrics/gynecology
- Osteopathic principles
- Pediatrics
- Psychiatry
- Surgery
USMLE® STEP 3 AND COMLEX® STEP 3 SYSTEMS
- General principles
- Immune, blood, lymphoreticular, and multisystem processes
- Nervous and special senses
- Behavioral health
- Skin and subcutaneous tissue
- Musculoskeletal system
- Cardiovascular system
- Respiratory system
- Gastrointestinal system
- Renal/urinary and male reproductive
- Pregnancy/childbirth and female reproductive
- Endocrine
- Biostatistics, epidemiology, population health, and medical literature
- Communication, ethics, and safety
USMLE® STEP 2 AND COMLEX® STEP 3 TEST QUESTION FORMATS AND STRATEGIES
- Read the question carefully
- Generate an answer, then look for the best response select the one that is most correct
- If unsure, eliminate as many wrong answers, then select your best option
Types of Questions
- Single-Item
- The most frequent multiple-choice format used on USMLE® Step 2 CK and COMLEX® Step 2.
- Typically starts with a clinical vignette followed by options in alphabetical order.
- Select the ONE BEST answer to each question.
- Sequential-Item
- Single patient-centered clinical vignette followed by 2 to 3 questions, each testing a different point.
- Select the ONE BEST answer to each question.
- Abstract/Pharmaceutical Advertisement
- Summary of the experiment, clinical investigation, or information concerning a drug.
- Interpret the abstract with questions on patient care, biostatistics, epidemiology, pharmacology, therapeutics, development, and approval of drugs, use of diagnostic studies, and ethics.
- Select the ONE BEST answer to each question.
USMLE® STEP 3 AND COMLEX® STEP 3 SUCCESS
For most students, achieving the highest possible score on the USMLE® Step 3 CK and COMLEX® Step 3 begins with setting aside more study time.
As the diversity of potential topics, USMLE® Step 3 and COMLEX® Step 3, are tremendous, most students improve their performance by completing as many questions as possible and then reviewing the questions they miss. The more questions completed, the more likely the student will achieve a higher score. Question banks selected should most closely resemble USMLE® Step 3 questions and with detailed answers and links to review articles. The more questions reviewed, the more likely the student will achieve a higher score.
With choosing the most comprehensive test prep and completing as many questions as possible comes the confidence that a high score on the USMLE® Step 3 and COMLEX® Step 3 will be achieved, and the student will have the benefit of selecting their first choice of a medical career path.